Category Archives: Mental health

Geddy Kramer favored video games set in dystopian worlds. He listened to music with angry lyrics. He dabbled with drugs. He desperately wanted to have sex. He watched porn on his iPhone. He saw a therapist for depression. He grieved, mostly in silence, over his parents’ divorce.

He was an American teenager in the 21st century.

One day in September 2012, Kramer sat in school, quietly mocking his classmates. And plotting to kill them.

“These … idiots have no idea what I’m writing,” Kramer typed into a journal on his phone. “I wish I could kill all of them, but there’s just not enough time and so much to do. And, like Dylan Klebold, I think I’ll have some followers. Maybe a few at least. All I have to say to them is kill those that stand in your way.”

Kramer killed no one in high school. His grasp for notoriety, his attempt to emulate Klebold and Eric Harris, the Columbine High School shooters, didn’t happen until almost a year after he graduated. On April 29, armed with a shotgun and homemade explosives, Kramer shot and wounded six people at the suburban FedEx warehouse where he worked. He was a would-be spree killer who took only one life. His own.

Many rituals follow mass shootings in the United States, prominent among them a search for meaning — for the hidden clues that would somehow make sense of why the shooter snapped; for the missed signals that, if detected in time, might have forestalled the tragedy.

But a close examination of Geddy Kramer’s final months finds no obvious cause for his rampage. It suggests no dramatic descent into madness. And, perhaps most important, it reveals nothing that Kramer did that necessarily would have alerted anyone to the looming assault.

Kramer’s case shows the difficulty of predicting and preventing acts of mass violence, and of understanding what drives its perpetrators. Common traits, including some form of mental illness, tend to define spree killers, experts say, but those same traits also stand out among many more people who never commit a violent act.

“If you predict every isolated, troubled young man is going to perpetrate a mass shooting, you would be wrong thousands of times,” said Jeffrey Swanson, a professor of psychiatry at Duke University’s School of Medicine who studies the nexus between violence and mental illness.

This examination is based in part on 600 pages of police reports, along with 33 compact discs of witness statements, crime scene photographs, and data from Kramer’s phone: text messages, his Internet browsing history, and his electronic journal, sarcastically titled “The Thoughts of a Nobody.”

Kramer’s writings, though often juvenile and profane, betray no delusional thinking or paranoid fixations. Rather, they reflect the banality of adolescence, returning again and again to Kramer’s indignity over how others viewed him — as such a loser that he appeared exactly once as a senior in his high school yearbook — versus his exalted self-image. Certainly, Kramer had problems. But the fact that he responded to them with extreme measures may be all that distinguishes him from any other disaffected 19-year-old.

Kramer left behind two mysteries, equally unsolvable and unnerving: why he harbored such rage, and how he concealed it with such ease before he erupted in violence.

At yet another facility, a man went so long without a bowel movement that he vomited blood. He died in an emergency room.

These episodes, drawn from government records, illustrate the myriad challenges facing Georgia as it transforms the way it cares for people with developmental disabilities, an investigation by The Atlanta Journal-Constitution has found.

Under an agreement monitored by a federal judge, the state promised four years ago to move all mentally disabled people from its psychiatric hospitals to homes in their communities. So far, 482 people have been deinstitutionalized.

But, the newspaper found, many appear to be no better off — or, in some cases, even worse off —now than when they lived in the state’s dangerous and dysfunctional psychiatric facilities.

Few lead meaningful lives in their new communities, according to a court-appointed consultant. They have little say over where they live, or with whom. Medical care can be sketchy. Often, group homes and adult foster homes don’t hire enough caregivers or don’t adequately train the ones they employ. Residents are dispersed across the state, sometimes far from family members or others who might keep watch over their treatment. If disabled people were simply warehoused in state hospitals, as their advocates often asserted, now it is as if they have been placed in small, isolated storage units that easily elude attention.

Most ominously, residents of many group homes have encountered similar patterns of mistreatment that plagued the state hospitals.

At least three-fourths of the facilities have been cited for violating standards of care or have been investigated over patient deaths or abuse and neglect reports since 2010. Officials have documented 76 reports of physical or psychological abuse, 48 of neglect, and 60 accidental injuries. In 93 other cases, group home residents allegedly assaulted one another, their caregivers or others.

Forty people died after moving into group homes. At least 30 of those deaths had not been expected.

Widespread troubles in those facilities prompted the state Department of Behavioral Health and Developmental Disabilities to suspend transfers in January – a delay, continuing indefinitely, that is likely to cause the state to miss a deadline of July 1, 2015, to complete the moves. Almost 350 disabled people remain in state hospitals, and many of them have profound medical needs that will complicate efforts to find acceptable homes.